-G U ID ED BY LAXM IM AM

-PRESEN TED BY RO O PA
(170611881010)

CO N TEN TS
INTRODUCTION
DEFINITIONS
CLASSIFICATION OF ABUSED DRUGS
SYMPTOMS
SINGS OF USE & DEPENDENCE
PHARMACOLOGICAL EFEECTS
THERAPEUTIC USES
ADVERSE EFEECTS
TREATMENT
CONCLUSION
REFERANCE

INTRODUCTION

DRUG
A drug is a substance (natural or synthetic)

when taken into the living-organism, may

modify one or more of its function.

D RU G
A B U SE
DRUG ABUSE is

the persistent
(continual) (or)
sporadic (random)
excessive drug
use inconsistent
with , (or)
unrelated to
medical practice.
Drug abuse goes
well beyond mere
misuse of drugs.

FA CTO R S W H IC H FA CILITATE
IN TIATIO N O F D R U G A B U SE
Ready availability of drug as in

case of doctor & medical students.

General public acceptance of the
use of mood modifiers such as
alcohol.
Increasing mobility particularly of
youth.
Peer group pressure.
An abundance (plenty) of
information about drug effects &
sources.
Lack of adequate publicity given
to harm full effects of these
agents.
Unstable (or) broken homes ,
socioculture pressure & social ills.

A PO TEN TIA L A D D IC TIO N M AY

STA RT & CO N TIN U E TA K IN G A
D EP EN D EN C E IN CLU D IN G D R U G
Following its medicinal use.
To achieve a sense of relief from

stress & tension of life.

To satisfy curiosity about drugs
effects.
To achieve a sense of
belonging , to be accepted by
others in the group.
To express hostility(or)
independence.

D R U G S O F A B U SE M AY B E
G R O U P ED IN TO
PRESCRIPTIVE
PERMISSIVE
PROSCRIPTIVE
DRUGS
DRUGS
DRUGS

P R ESCR IP TIV E D R U G S
These drugs are used therapeutically for their

beneficial effects & are available on a

physicians (legal substances) prescription.
The same drugs can be abused by vulnerable
individuals.
EG :
AMPHETAMINE,
ANALGESIC,ANXIOLYTICS,
BARBITURATES,BZD,
NON_BARBITURATES,
SEDATIVES_HYPNOTICS,
STEROIDS &
TRANQUILIZERS.

P ER M ISSIV E D R U G S
The use of these drugs is generally permitted

by the society as almost a norm(standard).

Eg :caffeine , nicotine , ethyl alcohol..
CAFFEINE:
TEA,
COFFEE,
COLA BEVERAGES.
NIOCOTINE:
SMOKING,
CHEWING,
INTRA NASAL ADMINISTRATION.
ETHYL ALCOHOL:
Readily available in a great variety of
beverages to adults in unlimited quantities.

P R O SCR IPTIO N D R U G S
Those drugs which have been placed under

street drug control to avoid their illicit(or)illegal

use.
Some of the medically used drugs like :
OPIOIDS ,
SEDATIVES ,
STIMULANTS.
when these drugs used for non medical
purposes belong to the proscriptive group of
drugs.
In addiction , marihuana & other hallucinogens
like LSD(lysergic acid diethylamide) which have
no established medical use belong to these
group.

DRUG DEPENDENCE
It is a state, PSYCHIC & sometimes also PHYSICAL
, now denoted as DEPENDENCE ,characterized by
behavioral and other responses include a
compulsion to take the drug.
HABITUATION
It is a pattern of repeated drug usage ,although
the actual physical need for the drug is minimal.
TOLERANCE
It describes the reduced effect of a drug resulting
from repeated exposure to a similar drug.
ADDICTION
It refers to compulsive drug usage ,the
necessity of obtaining the drug at any cost
,and appearance of withdrawal symptoms if
the drug is unavailable.
DRUG MISUSE
This term refers to improper use of medicines
in a way that can lead to acute and chronic

D RU G D EPEN D EN CE
It is a state , psychic &
sometimes also physical,
resulting from the interaction
between a living-organism & a
drug, characterized by
behavioral & other responses
that always induce a compulsion
to take the drug on a continuous
or periodic basis in order to
experience its psychic effects
Absents of the drug impairs the
ability of the person to function
in a socially acceptable manner.
Two distinct types of dependence

psychological(psychic)

dependence.
Physical dependence.

PSYCH O LO G ICA
L (PSYCH IC)
It denotes
theDcompulsive
D EPEN
EN CE
need to experience a

pleasurable drug reaction

, ranging from a mild
desire for the drug to an
over whelming(across the
goal edge) need to have
the drug at any cost
The psychic drive
requires periodic or
continuous use of the
drug to produce pleasure
or to avoid discomfort.

PHYSICAL
DEPENDENCE

It is an altered
physiological state
resulting from prolonged
use of a drug , & regular
usage becomes
necessary to avoid
intense physical
disturbances manifested
as the withdrawal (or)
abstinence syndrome.
Withdrawal reactions
are often (over and over
again) severe (dangerous
depending) on the drug
& duration of use.

classifi
cation ofabused drugs

Type

Example

Dependence
Liability

Opioids

Morphine
Diamorphine
Methadone
Oxycodone

Very
Very
Very
Very

General CNS Ethanol

Depressants Barbiturates
GENERAL
ANAESTHETICS (E.G.
No2 , Propofol )
Ketamine
Solvents

Strong
Strong
Strong
Strong

Strong
Strong
Moderate
Moderate
Strong

TYPE

EXAMPLE

Dependence
Liability

Anxiolytics &
Hypnotics Drugs

BZD
GHB

Moderate
Probably
Moderate

Psychomotor
Stimulants

Amphetamines
Cocaine
MDMA (Ecstasy)
Nicotine

Strong
Very Strong
Weak or absent
Very Strong

Psycomimetic
agents

LSD
Mescaline
Cannabis

Weak / absent
Weak /absent
Weak

TO O LS U SED IN D R U G
C O SU M P TIO N

D R U G A D D ICTIO N
SYM TO M S/B EH AV IO R S
Drug
Drug addiction
addiction symptoms
symptoms or
or behaviors
behaviors include:
include:

Feeling
Feeling that
that you
you have
have to
to use
use the
the drug
drug regularly
regularly -- this
this can
can be
be daily
daily or
or

even
even several
several times
times a
a day
day
Failing
Failing in
in your
your attempts
attempts to
to stop
stop using
using the
the drug
drug
Making
Making certain
certain that
that you
you maintain
maintain a
a supply
supply of
of the
the drug
drug
Spending
Spending money
money on
on the
the drug,
drug, even
even though
though you
you can't
can't afford
afford itit
Doing
Doing things
things to
to obtain
obtain the
the drug
drug that
that you
you normally
normally wouldn't
wouldn't do,
do, such
such
as
as stealing
stealing
Feeling
Feeling that
that you
you need
need the
the drug
drug to
to deal
deal with
with your
your problems
problems
Driving
Driving or
or doing
doing other
other risky
risky activities
activities when
when you're
you're under
under the
the influence
influence
of
of the
the drug
drug
Focusing
Focusing more
more and
and more
more time
time and
and energy
energy on
on getting
getting and
and using
using the
the
drug
drug

Marijuana and
hashish
Signs of use and dependence
can include:
A heightened sense of visual,
auditory and taste perception
Poor memory
Increased blood pressure and heart
rate
Red eyes
Decreased coordination
Increased appetite
Slowed reaction time
Paranoid thinking
Difficulty concentrating

Barbiturates &
benzodiazepines
Signs of use and dependence can include:
Drowsiness
Slurred (confused) speech
Lack of coordination (management)
Memory problems
Confusion
Slowed breathing and decreased blood
pressure
Dizziness
Depression

Inhalants...
The signs and symptoms of inhalant
use vary depending on
what substance is inhaled.
Some commonly inhaled substances include
glue,
paint thinners,
correction fluid,
felt tip marker fluid,
gasoline,
cleaning fluids &
household aerosol products.
When inhaled, these products can
cause brief intoxication &
a decreased feeling of inhibition.
Long-term use may cause
seizures and
damage to the
Brain ,liver and kidneys.
Inhalant use can also cause death.

Methamphetamine, cocaine & other

stimulants
Signs of use and dependence can include:
Euphoria
Decreased appetite
Rapid speech
Irritability
Restlessness
Insomnia (Sleeplessness)
Paranoia (Fear)
Weight loss
Depression as the drug wears off
Nasal congestion and damage to the mucous
membrane of the nose in users who snort drugs
Increased heart rate, blood pressure and temperature

Narcotic painkillers
Signs of narcotic use and
dependence can include:
Reduced sense of pain
Sedation
Depression
Confusion
Constipation
Slowed breathing
Needle marks (if injecting
drugs)

A D V ER SE EFFEC TS O F
D R U G A B U SER S
Damage gums & teeth
Stained nails & fingers
Hair fall
Psoriasis
Eye wrinkles
Brittle bones
Age spots
Lines & wrinkles around the
lips
Sagging arms & breasts
Uneven skin tones

TH E D IFFER EN CE B ETW EEN H EA LTH Y

& D R U G A B U SER B R A IN

D RUG S TH AT ACTIVATE G PRO TEIN CO UPLED RECEPTO RS

NAME

MAIN
MOLECUL
E

PHARMAC
OLOGY

EFFECT ON
DOPAMINE (DA)
NEURONS

RR2

Opioids

Mu-OR
(Gio)

AGONIST

DISINHIBITION

Cannabinio
ds

CB1R (Gio)

AGONIST

DISINHIBITION

Gamma
hydroxybut
yric
acid(GHB)

GABAbR
(Gio)

WEAK
AGONIST

DISINHIBITION

LSD ,
Mescaline ,
Psilocybin

5_HT2aR
(Gq)

PARTIAL
AGONIST

Mu_OR = mu Opioid receptor;

CB1R = Cannabiniods-1;
5_HTxR = serotonin receptor;

D RUG S TH AT BIN D TO IO N O TRO PIC

RECEPTO R & IO N CH AN N ELS
NAME

MAIN
MOLECULE

PHARMAC
OLOGY

EFFECT ON
DOPAMINE
(DA)
NEURONS

RR2

NICOTINE

nAChR (a2 b2)

AGONIST

EXCITATION ,
DISINHIBITION(
?)

ALCOHOL

GABAaR ,
5_HT3R ,
nAChR ,
NMDAR , Kir3
channel

EXCITATION ,
DISINHIBITION
(?)

BZD

GABAaR

+VE
DISINHIBITION
3
Kir3 channel = G protein-coupled MODULATO
inwardly rectifying potassium
R
channels;
PHENCYCLID
_
RR2
= RelativeNMDAR
risk of addiction; 1AGONIST
= non addictive;
5 = highly 1
INE ,
addictive.
KETAMINE
NMDAR
= N_methyl D_aspartate receptor ;

D RUG S THAT BIND TO TRANSPO RTERS O F

BIO G ENIC AM INES
NAME

MAIN
PHARMACOLO
MOLECUL GY
E

EFFECT ON
DOPAMINE
(DA)
NEURONS

RR
2

COCAINE

DAT ,
SERT ,
NET

INHIBITOR

Blocks DA
uptake

REVERSES
TRANSPORT

Blocks DA
uptake ,
synaptic
depletion

AMPHETAMIN DAT ,
E
NET ,
SERT ,
VMAT
ECSTASY

SERT>
REVERSES
Blocks DA
RR2 = Relative risk
of addiction;
1 = non addictive;
5 = highly
DAT,
NET
TRANSPORT
uptake
addictive.
, synaptic
depletion
DAT = dopamine transporter;
SERT = serotonin transporter;
VMAT = vesicular monoamine transporter.

Psychedelic Addiction
TR EATM EN T FO R
Therapy:

A B U SER

D RUG

In the past, doctors used a

shotgun approach to treating drug
addiction.
They were willing to try anything
to get their patients to kick the
habit,
even things that would seem
pretty crazy today.
For example, in the 1950s and
1960s,
drugs like LSD were used
experimentally,
In an attempt to treat .

Addiction Treatments Past and

Present:
oIn the past, society viewed drug addiction as a moral flaw.
oPopular "treatments" involved imprisonment, sentencing to
asylums (withdraw) and church-guided prayer.
o Not surprisingly, these methods were generally ineffective.
oToday we understand that addiction is a brain disease
characterized by fundamental and long-lasting changes in the
brain.
oModern treatments are based on scientific research.
o Treatment is tailored to the individual and typically involves a
combination of drug and behavioral therapy.
o Today's methods are very effective, with 40-70% of patients
remaining drug-free.

EARLER TREATM EN T

Victorian-era
treatments for
alcoholism
were
often both
ineffective and
inhumane.

 The idea of using hallucinogenic drugs to treat

Ibogaine Root

drug addiction was abandoned as the drugs

themselves became illegal.
However, addiction treatment with
hallucinogens is experiencing a renaissance
(recovery) with the increasing popularity of
Ibogaine therapy.
Ibogaine is derived from a root used in an
African religion to visit the ancestors.
Although illegal in the US, some 20 or 30
Ibogaine clinics are in operation worldwide,
primarily to treat heroin addiction.
Ibogaine is thought to rewire (Analyses) the
addicted brain as the patient undergoes the
intense multi-day treatment.
Ibogaine is very controversial for many
reasons, including the occurrence of fatal
heart arrhythmia in some patients.

TR EATM EN T O F D R U G A B U SER S
IN V O LV E FO LLO W IN G
D R U G S(used now -a-days)

TOBACCO

Relationship betw een the Im m ediate & D elayed

eff
ects ofD rug taking & D rug w ithdraw al
Acute

STATE
PROD
UCED
Effect

DRUG-TAKING

Rewar
d

Mechanis
m
Activation of
mesolimbic
DA pathway
?other
reward
pathways

Tolerance ,
dependenc
e
Adaptive
changes in
receptors,
transporters,2n
d

messengers,et
c. (e.g.

Acute abstinence
DRUGWITHDRAWAL

Withdrawa
l
syndrome
Uncompens
ated
adaptive
changes
(e.g. DA ,
glutamate
)

Craving
Not
known

TREATM EN T
Opioid withdrawal

CO N CLU SIO N
Today no single pharmacological

treatment (even in combination with

behavioral interventions) efficiently
eliminates addiction.
Although its cellular mechanism is unclear
, data in rodents (mammals of the order
Rodentia) convincingly demonstrate that
this compound can reduce self
administration in nave (inexperienced) as
well as in drug-experienced animals.

REFERAN CE
BASIC & CLINICAL PHARMACOLOGY 10th
edition by BERTRAM G & KATZUNG.
ESSENTIALS OF PHARMACOTHERAPY-by F.S.K
BARAR.
PHARMACOLOGY & PHARMACOTHERAPY-by
SATOSKAR , NIRMALA N.REGE & S.D
BHANDARKAR.
7th edition RANG & DALES PHARMACOLOGY
(INTERNATIONAL EDITION)-by ELSEVIER ,
CHURCHILL , LIVING STONE.
INTERNET.

 THANKING ALL OF MY LECTURERS

FOR
GUIDINIG
ENCOURAGING
SUPPORTING &
MAKING MY SEMINAR SUCCESFUL!!!!

A SPECIAL THANKS TO LAXMI

MAM FOR BEING REFERENCE TO

MY SEMINAR